Intensive Care Medicine

, Volume 25, Issue 10, pp 1105–1110

Influence of prothrombin complex concentrates on plasma coagulation in critically ill patients

Authors

  • T. Staudinger
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • M. Frass
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • C. Rintelen
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • P. Quehenberger
    • Department of Chemical Laboratory Diagnosis, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria
  • O. Wagner
    • Department of Chemical Laboratory Diagnosis, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria
  • B. Stoiser
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • G. J. Locker
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • K. Laczika
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • S. Knapp
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
  • H. Watzke
    • Department of Internal Medicine I, University of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria Tel.: +43(1)4 04 00-44 92 Fax: +43(1)4 04 00-44 98 email: thomas.staudinger@akh-wien.ac.at
ORIGINAL

DOI: 10.1007/s001340051019

Cite this article as:
Staudinger, T., Frass, M., Rintelen, C. et al. Intensive Care Med (1999) 25: 1105. doi:10.1007/s001340051019

Abstract

Objective: To evaluate thrombogenicity of prothrombin complex concentrates (PCCs) in critically ill patients.¶Design: Prospective clinical study.¶Setting: Medical intensive care unit at a university hospital.¶Patients: 16 consecutive patients suffering from acquired deficiencies of coagulation factors and with either overt bleeding from any site or a planned invasive procedure.¶Interventions: 2000 factor IX units of PCCs intravenously.¶Measurements and results: Prothrombin time (PT), activated partial prothrombin time, fibrinogen, platelet count, plasma levels of coagulation factors II, V, VII, VIII, IX, X, antithrombin, protein C, thrombin-antithrombin complex (TAT), prothrombin fragment F1+2, and the fibrin degradation product D-dimer were measured prior to and 1, 3, and 24 h after administration of PCCs. PT as well as coagulation factors II, VII, IX, and X, TAT, and F1+2 showed a significant increase after administration of PCCs. All other parameters remained unchanged.¶Conclusions: Administration of PCCs induces thrombin generation. No evidence for induction of disseminated intravascular coagulation in biochemical terms could be found. When rapid correction of acquired coagulation factor disturbances is warranted, the use of PCCs seems reasonable, but the elevated risk of intravascular thrombus formation should be kept in mind.

Key words Prothrombin complex concentratesThrombogenicityIntensive careDisseminated intravascular coagulation

Copyright information

© Springer-Verlag Berlin Heidelberg 1999